Meds (Take 2…)

(GOOD numbers! 5/1/21 with 500 mg Glucophage.)

I’m back on a low dose of a type 2 diabetes med.

It sucks to have to admit that the YEARS of lifestyle changes I’ve made and adhered to just weren’t enough for this stage of life.

I’ve talked for years about working so hard to get off of meds. And I have spent 8+ years backing it up with a lot of hard work to stay off meds. I had some major heartburn along with a few tears, over having landed back in the land of pharmaceuticals. I feel like a failure on some level. Yet I’m not dumb. I don’t want to die or loose limbs or suffer organ failure and I KNOW that’s the possible result if I continue to deny the situation. And throw in that I did a whole lot of damage for many years. As my friends who were there 10 years ago remind me: I was warned that if I could get off of all the meds and embrace a different lifestyle; at some point meds might still have to be re-introduced.

It appears that now is that time.

Hello again. (I’m saying that in a flat, unenthusiastic, bored-teenager tone…)

I held my own for a long time. Eight years give or take. Got off meds and stayed off meds. Then menopause hit. Perimenopause to be precise. It hit me hard, backed over me, peered out the window and ran over me again just for good measure. In doing some research I’ve learned glucose resistance is common for women during this stage. I’m metabolically messed up anyway… So… I have to be extra careful and mindful. It has been increasingly obvious that I wasn’t going to wait this out with familiar tactics and tools.

(Crappola lines and numbers. 3/27/21)

After some stalling and hand-wringing, I went to the doc to ask for help taking action before things got totally out of hand. I knew – thanks to my trusty Continuous Glucose Monitor (CGM) that my numbers were not great. You want that line FLAT and low as much of the time as possible. Bloodwork backed up my concern that things weren’t where I wanted them. I was doing everything I knew to do, everything that had worked up to this point. Exercising, lifting weights, sleeping, drinking lots of water, no alcohol, low carb/healthy fat foods, trying to limit stress. That line should have responded by flattening out and laying low. It stayed jagged with random big spikes.

We talked about all the options and decided we could do one of two things; let me keep doing the things I was doing and see what happened or we could introduce a little pharmaceutical assistance and see if my body appreciated the help.

It was up to me.

I opted for some help.

My body REALLY appreciates the medical assist. I need some help to get through menopause and not fall neck deep back into full-blown type 2 diabetes. Three weeks on the new med and I have good numbers and feel so much better. It was the right thing to do.

I keep thinking about the fable of ‘The Boy Who Cried Wolf’. I was that character for oh-so-many years. For decades I would go to docs overweight, miserable, escalating health issues and totally unwilling to change. They would ask about my health habits and I would lie. To their faces. I would lie. I would plead with them to give me a magic bullet or cure me or solve the problem. The part I never voiced out loud was that I didn’t want to have to do any work. I wanted something to magically fix me and I thought that if I told them again and again that I was doing everything and I needed help – they would finally stop making me work at helping myself and they would just FIX IT.

That’s not how it works. Especially when there are some much bigger/deeper issues at the core.

Shame. SO, so much shame and wildly ineffective coping mechanisms for dealing with it. It kept me from taking action and making changes for years. I would tell docs I was doing ‘everything I could’ and leave their appointment and cruise through a drive-through to drown the shame in a value meal… I was binge eating and hiding it. I was not exercising. I was not being compliant with meds/protocols. I didn’t know how good life could be running and adventuring and being healthy — I thought the only thing that could provide that kind of comfort was food… Took a really good therapist to help me begin to untangle that mess.

Fast forward: I found health, therapy and life. It’s a long story. You can buy the book. Literally. πŸ™‚

Now I’ve been sitting in a docs office telling her I am doing everything I can. And I need help. I became uncomfortably aware of all the times I had said those words to health professionals and NOT MEANT THEM. And I’m proud of myself for being brutally honest and upfront and battling the shame this time. This time I really genuinely meant them.

I’m on 500 mg of Glucophage. It’s a medication I know well. It’s meant to be combined with lifestyle changes. It does have some side effects; gastrointestinal ickiness. Still doing ALL the things I was doing to help myself and getting a little medical assistance to get my numbers to go/stay low.

It is working.

I am proud of myself for knowing when to ask for help. I’m proud of myself for taking the help even though I was also battling the feelings of taking a BIG ASS STUMBLING STEP BACKWARDS. I vowed when I made all of those changes almost a decade ago that I would try to do the right thing for my health moving forward. And I am keeping that promise to myself. Even with some mixed emotions about having to swallow a pill; this is in fact the very right thing for right now.

Laughter is damn good medicine.

My momma used to say ‘you better be able to laugh at yourself, cause others certainly will.’ And she didn’t mean it in the ‘get yourself some confidence and have a spine and who cares what the world thinks’ if you knew my kind-hearted, loving, gentle momma she meant it in the ‘life is funny and laughing is fun and just lighten up – life is way, way, way too short to be taking yourself so seriously’…. I have found laughter to be healing, provide peace and disarm even the grumpiest of people at times.

‘A wonderful thing about trueΒ laughterΒ is that it just destroys any kind of system of dividing people.” –John Cleese.

I’m a BIG fan of laughter. And I swear the older I get the more I have to laugh at myself in regards to my what-the-hell-happened-to-my-memory or no-filter-thinking or crappola eyesight. Having the privilege of living into my 50’s — there is simply some funny shit that happens with age.

So with that set-up… Let me tell you about a recent trail episode.

It was cold and still icey in places from a recent snow/thaw. My running friend and I are doing this local 2.5 mile climb up a place I love to run called Cline Buttes. It’s a fire road/bike trails with a 1,000 foot hill. We tackle it each week; on the same day and keep track of our times. We’re aiming to be fast badasses and we’re working on it one step at a time. Right now I’m less ‘fast badass’ and more ‘just don’t stop hiking until you hit the top no matter how slow you go’. (Side-note; you can in fact go so slow that your trusty and beloved GPS watch asks if you still want to be recording this ‘run’ or are you done? Fact.)

Anyway, we focus on hiking up this hill to get to the gate. There’s a gate to a utility road/cell tower enclosure at the top; we hike up as hard as we can, tap the gate, turnaround and run back down. Some version of that is the weekly goal. We’re trying to hike harder and run faster. Simple. HARD as hell, but simple and rewarding to gauge progress each week.

Running back down, every so often on the downhill one of us has to stop and pee. Trail running? No problem. Check for other peeps. Hike 10 feet off. Face your bum away from potential oncoming traffic. Squat. Resume running. SIMPLE.

This time descending off the hill I decide that if I take any more running steps I’m going to pee my pants. There’s no waiting this one out until I get back home. So I tell my partner ‘Hey… I know we’re on a bit of a sidehill, but I really have to pee. Gonna climb over that discarded corrugated/culvert pipe over there on the side of the road and be right back.’ It seemed like as good a place to ‘hide’ as possible given the hill, potential bike traffic that sneaks up on you. Plus I am a SUPER speedy pee-er. Like – peeing on trail has to be close to a super power for me. I’m good. Really good. But I digress.

Remember I said it was icy?And we’re on a fairly steep side hill? Right?

As I step off the road and I am on a downhill sloped patch, JUST ABOUT to straddle the discarded culvert pipe which is at least 3 feet round… My running partner YELLS ‘BETSY. WILD ANIMALS!’

I stop mid-straddle, whip around to see what in the holy hell she is yelling about…

That quick turn threw me off balance on the hill. My only-planted foot slips on ice.

I go ass-over-tea-kettle over the frozen, slippery pipe. Like, in my mind, it was almost competitive gymnasts quality mid-air, somersault.

A really convenient and soft patch of unmelted snow breaks my downhill fall and keeps me from rolling the 2.4 miles downhill to my car.

I am so startled to find myself on the ground, I pee my pants.

I hop up as quick as I can trying to do a simultaneous pat down to make sure I’m not broken or bleeding AND keep from falling back down the steep side hill AND I’m also frantically looking around for a tyrannosaurus rex or cougar or polar bear.

I turn to my friend who has a totally shocked look on her face and I’m staring at her, mouth soundlessly agape and waving my arms around wildly like ‘WHAT ANIMALS? DO WE HAVE TO RUN FOR OUR LIVES?” and she says ‘uh… I thought maybe an animal had taken up residence in that discarded pipe and you should be careful not to disturb them.’

We stared at each other for about 5 seconds. I said something really smooth like ‘I PISSED MYSELF’. And we both started to laugh.

We laughed so hard that she finally sat on the ground. The next day my ribs were sore from laughing so hard.

We laughed for probably a full 5 minutes. At some point she asks ‘are you OK?’ and it was WELL after we’d laughed and tried to stop laughing multiple times. I said ‘yeah. I’m good. (sarcastic font) Thanks for asking me NOW.’ That launched another fit of laughter.

The worst that happened was I peed my pants. Not the first nor the last time that’s gonna happen. And to be honest, it’s why I wear exclusively black tights for running. I learned that lesson EARLY on; with black leggings/tights no one can EVER tell. πŸ™‚

The best part? A deep and happily exhausting belly laugh with a friend and another great trail story to tell.

Laughter is in fact good medicine. (Even the Mayo Clinic says so. )

Continuous Glucose Monitor (CGM)

I’ve been using a Continuous Glucose Monitor (CGM) for over a year now to help me keep type 2 diabetes at bay. I knew it was an amazing tool at the start, but a year of steady use and I can happily and without exaggeration say….

It is life changing.

Being able to contrast life trying to reverse type 2 diabetes 8 years ago using meds/insulin/finger-sticks/blood tests with staying healthy eating low carbohydrate and right now having a gadget to give me real-time feedback about my choices with the swipe of my phone…. More than a few times I’ve had deep, grateful moments of realizing I have instant info and can take action to make things different. Right now! HOLY SMOKES! That feedback and implementing those changes in the past would have taken MONTHS of waiting and follow-up blood tests and endless finger sticks to basically GUESS at a next best direction.

It’s a small ‘button’ I wear on the back of my arm for 2 weeks at a time. It collects data 24/7. When the two weeks are up, the app warns me – and I insert/attach a new one to the other arm… SMALL, tiny, flex-tubing inserts in my arm. DOES NOT hurt, I barely feel it or notice it at all. PROMISE.

I can instantly scan the ‘button’ with the app on my phone and get information 24/7 about what’s going on in my body.

Happy to see the entire line in the green bar… That’s my goal! STAY IN THE GREEN!

I can tell how stress, sleep, activity, food are all impacting my glucose. Hell – I can tell when I am starting to get sick or accidentally got some sugar in food.

ShingRx shot threw my body for a loop. Wasn’t just my imagination — we could SEE it….

It’s an awesome, unobtrusive ‘detective’ sitting passively on my arm and collecting data for me! It allows me to make the ‘next best choice’ and take action for my own health. Over short periods of time I can use the information it provides to figure out what works best for ME. {Obligatory reminder… This little gem of a tool is in addition to regular health care. It is NOT a replacement for regular visits and care.}

I am metabolically – pick your favorite word – deranged/damaged/fragile. I did years and years of ‘training’ my body to work and respond in a certain way. That’s the nice way to say my lifestyle and food choices did some hefty damage. Now I get to live a slightly different life than the normal person to stay my healthy best and off meds. I now have this great tool that gives me positive reinforcement and helps me answer questions in real time about me and my body and how it reacts to what I do/put in my body.

You want a concrete, personal example of what’s different for me? I aim to keep my glucose readings to stay from 80-120 mg/dL (The green stripe on the screen shot above). I work to keep it ‘between the lines’. It would be amazing if I could keep it at 80 mg/dL around the clock. But bodies, life and glucose don’t work that way. πŸ™‚ I took insulin and meds for years. Now I don’t. I would love to never, ever have to take any of them again. So, given that Type 2 Diabetes is largely a lifestyle disease – the results rest in large part on me and my day-by-day choices and habits. I use food and activity to control my health and stay out of the diabetic range. So for me, I try to move 6 days a week with sweat and intention. I try to keep my net carbs at/below 50 grams a day. THAT seems to be the sweet spot my body works at and responds to the best. I now know all of this life-changing information because I have a year of working with a CGM. The combination mentioned above is what gives me consistently good readings. πŸ™‚

I do pay out of pocket for this sucker. Insurance companies don’t want to pay for prevention. (Yes… I’m sitting here cussing about that like I do on the regular…) Yet I am lucky that I can find some creative ways to make it work because a year into using this device I KNOW I can take smart, educated, fast choices for my own best long-term health. I would encourage anyone who knows that they have a pre-diabetes/diabetes diagnosis or one they suspect a diagnosis is looming around the bend to think about asking your Doc to prescribe one of these. This could be the tool that helps you avoid that specific and dangerous footpath and puts you back on a health track. If you’re pondering it, wondering about it all – please reach out! I’m happy to talk about any/all of it. I was a skeptic. I wasn’t sure it could help me. I thought it would be a pain in the ass or wouldn’t be accurate or would hurt 24/7…. But a year into using it I have too much hard evidence that this thing is helping me make sustainable, healthy changes that work specifically (and maybe only!) for ME. It’s not a mass-market diet or silver bullet or cure-all; but it’s one hell of a tool to help you find your best long-term health.

Special thanks to Dr. Mark Cucuzzella and Christina van Hilst, DNP with the West Virginia University Center for Diabetes and Metabolic Health for the help and guidance in this whole year-long process. If you are interested in using this technology reach out to their center at 304-596-5038.

Ode to a visor. {My hair can be an asshole at times.}

WIND was ferocious at the top. ‘Can I take a picture?’ ‘Yeah but HURRY UP.’ We climbed, we photo’d, we skedaddled back down.

I always chuckle to myself when people ask me about the epic views I get to see hiking/running in and around the amazing Cascade Range of Oregon. I nod and say yes, nature is in fact glorious. She doesn’t have a bad view.. Cause, I mean c’mon…

But I chuckle because… THIS… This is my reality. This is what I saw for 3+ hours today.

THIS is what I look at on the day-to-day when I’m training to do a trail race/event. I live in Bend and have access to amazing outdoor spaces. I treasure every minute I get to be outside. Yet, views from the mountain top aren’t what it’s all about for me. I honestly have just as much love and appreciation for being able to watch the ground move and change under my feet for hours on end. I may not be able to reliably identify a mountain peak, but I can often tell you precisely about rocks, mud, ditches and downed logs on local trails.

I think both the view and the journey are deeply rewarding.

One of my favorite memories from my 100 miler was at the finish line of Mountain Lakes 100. It boasts that runners pass 25 mountain lakes on this jaw-droppingly scenic course. He’s my friend now, but it was Colton’s first 100 mile finish too and at that time I only knew we were both now 100 mile FINISHERS. His parents were there to support and crew. We were all milling around the finish area, limping, whimpering, trying to figure out what in the hell had just happened to us after almost 30 hours of moving. I hear his mom say ‘Colton, were the lakes beautiful?’ and Colton’s reply with much exhaustion and a big fat bold question mark was ‘there were lakes?’

I remember that I laughed and butted in to say ‘I didn’t see any lakes either!’

I wear a visor for a variety of obvious, functional reasons; but it’s also a physical blinder to keep me focused on taking one step at a time. If I’m tackling something tough, I tend to do best if I can focus on the 8-10 feet directly in front of me. NOT the big picture. Not the people around me. Not what’s halfway up the hill and still distressingly *insert whining* FAR AWAY…. I do really well if I focus on where I’m going to put my foot in the very next step. Then the next. Repeat over and over and over again.

And I love a good visor for other reasons too. I mean, beyond the fact that my big head doesn’t fit in most hats AND then add in my hair… Lordy. My hair. She has her own zip code. My hair can be an asshole to be honest. I learned early on in my running adventures that a visor meant I didn’t have to try to control that mess on top of my head, no headache and I got all of the other benefits on top of being a tool to keep me focused on the work needed in the moment.

Once I have my running shoes on, my hydration pack, gloves, whatever else… The visor is usually the last thing I put on before we head out. I put my head in a natural, comfortable position and put the visor on carefully so that my view is very purposely restricted to what’s directly in front of me. I only want to be able to see 8-10 feet right off my toes. For good reason. Today’s challenge was trying to get up and down Gray Butte. One step at a time. I knew I needed to focus.

We’re about 2.5 miles in at this point in the picture and I want to go to the top, near that tower…

For two+ hours of climbing THIS was the my view from under the edge of my trusty visor…. While I worked to reach the top of hill.

+

We hit the trailhead, I get ready at the car. I try to do the same things in the same order – so nothing gets forgotten. I tie my shoes, make sure I have everything in my hydration vest pocket-by-pocket and put my visor on. While I’m going through that comforting routine of getting ready for a harder effort – I’m also mentally giving myself a pep talk, setting the stage for how I want to ‘show up’ for the run. Today it was these three points:

  • Stay in your lane Hartley. Doesn’t matter what ANYONE else is doing out there today. Comparison is NOT your friend. Give it YOUR best.
  • One foot in front of the other is the ONLY way to get there.
  • Don’t get lost.

Then we head out.

One foot in front of the other. Giving it my best.

Looking at the 10 feet of earth off of the tip of my shoe for where to step and land and push. I glance up from under the visor every few strides to make sure I’m roughly on the trail and headed toward the top.

Moving forward. Picking my next best step. Trying to reach the edge of the 10 feet my visor gives me, so I can check out the next 10 feet to cover .

Savoring the view of the ground while continually moving forward and eyeing the horizon. Who says we can’t have it all?

Chafing.

In ultra running there is a basic understanding that you are going to suffer.

One of the keys to doing these endurance events, and enjoying them, is learning how to suffer. Our miles and hours of training aren’t just about physically preparing for these adventures, terrains and distances; it’s also about getting our mind ready to go along for the trip and be ON OUR side. So, we do things like run back-to-back long runs on really tired legs to learn what suffering feels like. By running through it we learn we can push through so many perceived physical limitations that our mind throws down in front of us.

And then, well, then there’s unnecessary suffering. Suffering that simply becomes those classic and indelible lessons in ‘Yo! pay attention! Let’s try to not freaking do that again…’ Sometimes it’s the weather, or a trip-and-crash-on-your-face, poor navigation, equipment malfunction, Mother Nature’s obstacles and then there’s…

Chafing.

Chafing is one of those lessons that I (we) learn, then re-learn and eventually laugh at the ridiculousness of re-learning yet again. Some chafing you know is going to happen – and you use your Squirrel’s Nut Butter (SNB) slathered on to prevent it. Some you can feel as it’s happening and maybe even do something to cut it short. Some chafing you only discover in the shower. I’ve shrieked and squalled a time or two (200?) when water hits chafe I didn’t know was there. I’ve hesitated getting in the shower KNOWING when water hits the sore spot it’s gonna be a stinging, searing pain in the butt. (Not really a pun… More like an admission…)

Chafe sucks.

So this past weekend I was wearing some 3-year old trusty running tights that have been faithful companions on many runs/hikes and are still in visibly good shape. I put them on in the morning and thought they were feeling a little crooked in the crotch. But hey, it was early in the morning, I hadn’t had much coffee and I figured I would adjust things at the trailhead when we started. In the very back of my coffee-deprived brain I thought it wasn’t the best plan. I had a vague recollection of maybe having been in this situation before and wishing I had just shucked them and picked another pair of running tights… But these had never betrayed me before. I was pretty sure it would be OK.

I knew within the first two miles that they were going to maybe/sorta cause problems. Manageable stuff, but still – they were gonna be trouble.

About 4 miles in on a 16 mile day they started to chafe me. It was raining lightly and I could feel water running down my back so I knew chafing was likely going to happen no matter what. But I could also feel the sweat and water running down my butt crack – and my capris were getting soaked…And the chafing that started prior to the rain falling, was building …. um…. navel to ass crack.

I carry a small container of body lube with me for such instances. Almost all runners do. And trust me we can also get WILDLY creative with ANYTHING in our pack if we can’t find our lube… (Pro tip: Don’t use any kind of lube/chapstick/tube-of-anything from any other runners pack… You’ve been warned.) But this time – I had a small tub of SNB and I used the whole thing. I kept adjusting things trying to find the spot where the seam wouldn’t cut me in half. About 10 miles in I knew the chafing was going to be scream-producing at shower time. It was bad and getting worse. And we had miles to go… It was funny. I mean, if you can’t laugh at yourself — others will. Hell… My trail partners will laugh at me whether I laugh at myself or not. But I was trying to find a way to limit the carnage from those stupid tights as we moved along…. At one point I was calculating ripping my pants off and walking out of the wilderness pants-less except I was pretty sure that was a misdemeanor with like a $5,000 fine and maybe a lifetime ban from national forests….

I kept thinking there is a lesson in preventing some levels of suffering and yet there is learning in all suffering…. Which means I was technically winning (*cough*, *cough*) either way.

So back to my initial comment; we learn to suffer. Some of us seem to have a better ability to manage it, some of us have to really learn how to keep going even with our brain screaming at us to STOP. Running oh-so often provides lessons that apply well beyond the trail if we pay attention. One of the many, many reasons I love running.

Beyond chafing this was also one of those life-reminders that we need from time to time that sometimes we simply have to trust our gut. I knew something was just NOT RIGHT, right at the start. I knew the second I put those tights on that our years together were at an end. They felt scratchy and off and crooked. I wanted to trust, and I was wrong to ignore my gut that was saying the trust was lazy or misplaced or optimistic. Twenty-four hours post-run I was still walking around with a very wide-legged stance and sitting gingerly and laughing and grimacing.

The irony in all of this — is that all the training I’ve done to learn to suffer is part of what got me through this entirely avoidable situation. I mean let’s be honest, there are so many other chances to learn to suffer in our world, that fighting your tights shouldn’t be one of those lessons.

Mending a friendship.

Middle Sister, Pacific Crest Trail, Three Sisters Wilderness. Picture: Michelle Thompson

I ran and hiked 34 miles (52K) last Wednesday for my 52nd birthday. This was my first ultra distance adventure since the end of 2017. Five day after the run I’m still avoiding stairs and in the process of losing a few toenails, yet I am also enjoying a huge sense of accomplishment and feeling like I have welcomed back a long-lost friend.

November of 2017 I sought treatment for Binge Eating Disorder (BED). I had a lifetime of weird habits, horribly convoluted relationships with food, distorted body image and non-existent emotional coping skills. Yet I never knew it had an actual name. It does. Or that other people suffered like I did. They do. Or that it could be successfully treated. It can. I thought it was just me and I was ‘broken’ and food was an adversary I would fight my entire life. I would soon learn that for me, BED wasn’t actually even about food at all. I had developed ALL kinds of ways to deny, hide, manage the problem. (Blog here)

I had to take some important steps right off the bat. One of those steps was that I needed to back off of running. Running and coping and food were ALL tangled up and confused in my mind. In the desperation to hide what I couldn’t name, but absolutely knew was not normal, I had somehow turned running into a weapon. Pretty much overnight running went from being a friend to being an enemy.

To start the healing – I had to break those convoluted relationships up. It tossed ALL the things in my still-mostly-new-to-me healthy life into wild disorder. The only way I thought I knew to manage my weight and blood glucose was through running. with running in a greatly reduced role, I instantly started gaining weight and had to really watch my glucose readings as I learn how to manage these relationships independently. As someone who’d lost significant weight and gained an abundance of health through running; it was terrifying for me to grapple with running NOT being part of my life. And while I missed running, oddly I also started to fear, dislike, not trust running because it would trigger intense binging urges…

Ugh.

It’s been the past 6-8 months where I finally started to understand all the parts of the work I am doing were finally coming together; I was healing and getting stronger and even I could see it.

Time to hit the trails.

I stepped onto the dirt last Wednesday morning at 5 AM, headlamp blazing, with my friend Michelle Thompson, to leg out 34 miles (a course designed by Michelle). I wanted to see if I’d done enough work that running could be back in my life and not be a trigger for the eating disorder. And let’s face it; I’m 52 and if I’d clung to my old habits I wouldn’t even be alive to try this crazy experiment. And I know that. So I simply enjoy the hell out of each year that I get to celebrate being another year older. So this year we ran in the mountains. Climbing hills and crossing water. Stopping in our tracks to look at toads, rock formations, animal tracks (cougar!), flowers, wildfire burn scars and mountain peaks that are some of the prettiest in the whole world. Peeing in the woods – and in my own shoe at mile 3. Filtering our own water. Laughing, joking, crying and sharing trail-time with a soul-sister. Meeting friends at the end who came to cheer on the adventure. It was a magical day. Sitting here 4-5 days post-run when the binge urges would normally be active and showing themselves in full force; there’s only sore muscles, black toenails and some pretty soul-deep peace and calm. And I’m so happy to be feeling these feelings.

This was a carefully considered experiment with running to see if I could put all the pieces together and if we could all be friends again.

It really was a reunion of sorts.

A very happy reunion.

{Important note; as I worked toward this ‘experiment’ and continue to work to bring running back to a healthy spot in my life, my therapist is supportive and fully aware of what I’m doing.}

In the midst of COVID-19 things have gotten worse for those with previously stable eating disorders (here). I kept hearing anecdotal stories from friends about how their ED’s were out of control. I knew I was battling it as well. Some people are learning about eating disorders for the very first time.

You are not alone. No matter how twisted your world is with food/activity; you are NOT alone. Click here for resources that are free or low cost.

There is hope and help. You can heal from eating disorders.

South Sister, Pacific Crest Trail, Three Sisters Wilderness. Picture; Michelle Thompson

Obesity and COVID-19.

I have a big space in my heart for those who are learning to be active, and those living with type 2 diabetes and obesity. I was firmly in those worlds for decades; I know the fear, shame, challenges. I also know how much it meant to be surrounded by people who believed I could change. Day by day, it would still take years find health and they stood with me.

It was a huge mountain.

I want to repay that stalwart kindness and collective support by helping others. Helping others understand that breaking out of those dangerous, non-linear ‘health holes’ is worth every single drop of sweat, every tear, setbacks and sore muscles. Health, not weight is what I focus on as a person and as health coach.

Social media has undeniably been a significant tool in connecting me to the people who want help and those who work to help others. I have been off of social media for 100+/- days now. (Blog here…) I was pretty content to stay away. The recent headlines and conversations surrounding obesity/COVID-19 have me re-thinking my self-imposed social media ban and how I really desire to be part of these growing and on-going conversations.

Even being surprised, like everyone else, by the daily developments in our world I still found myself shocked and upset to see obesity grabbing some of the current headlines and a jarring one at that:

Obesity puts you at greater risk of severe illness and death from COVID-19.(Study here explains the details of why.)

Obesity with a side of panic and public shaming. A not-at-all-awesome combination.

Early in the pandemic response; the fat-shaming was driving me a wee bit cray-cray. ‘The mask isn’t for COVID-19 it’s for the dreaded COVID-19 POUNDS….’ comments/memes. As if the worst thing that COVID-19 could dish out was some weight gain. For those with shame around their bodies, eating disorders, body dysmorphia or even teeter-tottering self confidence those messages aren’t helpful. They become hyper-amplified with the fear and panic surrounding the pandemic responses. None of it is funny or harmless. Those of us who align with various ideologies around fat and health are familiar with ‘nothing is worse than being fat’ mentalities, jabs and jokes. Sadly familiar ground for some of us.

Then things escalated.

I struggled writing this blog. What has been largely personal and private battles for individual health has become a matter of increasingly urgent public health discussions. It felt like it was a slow burn when it was ‘just’ an obesity epidemic and now it’s full throttle as COVID-19 pushed the additional perils of obesity to a new forefront. People assume they can look at you and know what you eat, how much you move, what health issues you may or may not have. Public comment and scrutiny like never before. Meanwhile obesity can not be resolved with an overnight magic bullet so those living with it can only take baby steps to change their life and health outcomes. Shame and panic have never worked to help people make lasting changes.

If you’ve missed them; here are the headlines…

‘Having obesity, defined as a body mass index (BMI) of 30 or above, increases your risk of severe illness from COVID-19.’ (CDC)

‘An estimated 160 million Americans are either obese or overweight. Nearly three-quarters of American men and more than 60% of women are obese or overweight. These are also major challenges for America’s children – nearly 30% of boys and girls under age 20 are either obese or overweight, up from 19% in 1980′ (Source: IHME)

‘National surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives.’ (source NEDA)

People who are obese are in greater danger of being more ill/dying with COVID-19.

The personal layer that I’m aware of for myself and many others, and can not be ignored, is that woven into the mix is Eating Disorders (ED)… In elevating this conversation to a very public forum, where everyone can comment and opine, we’re inadvertently pushing into the world of ED’s as well. And in my opinion, obesity and ED’s are not something you can simply untangle or isolate or easily explain and throw COVID-19 into the mix and you have a bonafide shitstorm. This is a twisted and difficult but excellent time to help with some public education and stigma-breaking. I don’t have the answers, but I can’t ignore that the conversations happening are really important for us to be having.

Prevention of being infected with the virus is the key for all of us. Attention to improving overall/general health markers and being at a healthy weight is also important for at least 160 million of us. Suddenly what most of us were able to manage as a more personal shame/issue/problem or at least as a ‘local’ problem that only involved those who physically interacted with us is now very PUBLIC and callously and carelessly being discussed ‘about’ us. Piling shame on shame never helped anyone heal or grab hold of new habits or feel good about the slow, baby steps they’re taking to head in a new life direction.

I too am confused. And scared. I’m wondering what to think and who to believe and how to help those who need help. Meanwhile I have to work hard to stay focused on balancing my own mental wellness while living in a body that is healthy and yet looks visibly overweight…

How do we publicly talk about health and obesity without shaming those who struggle? That’s the core issue I am interested in. COVID-19 adds another urgent health layer on top of a really complicated problem. I don’t have answers, but I have ears and a willing spirit and I’m not afraid of the tough conversations or the hard work.

And I know, from hard-fought personal experience, that the view from the top of the mountain is always worth the climb, no matter how long it takes. And this is one hell of a mountain…

Deleting apps…

I don’t know about you but this is my first global pandemic. Annnddd…. I’d be totally fine if we never, ever had to experience this again.

I don’t want to gloss over the serious nature of the events gripping our world right now. It weighs heavy on my mind and heart. Yet as the panic began to ease up a bit this Spring, it created the chance for meaningful conversations with friends that we might not normally make time for. Friends began sharing about their personal ‘silver-linings’, or the smaller, more nuanced lessons they were learning about themselves and their priorities for life during this time of turmoil.

Some of the lessons I’ve learned seem to be universal; Don’t get low on TP, working from home has a distinct converse relationship to personal hygiene and 20 seconds is a really, really long time to wash your hands. Also fascinating to me? Most of us hadn’t really EVER been washing our hands correctly anyway. Who knew?

I had my own story about personal growth. This crisis handed me a much needed reset. I went from complaining or rejoicing or chasing after the mundane and relatively trivial in the day-to-day to caring deeply that I had a roof over my head, a job, and no one I knew was sick. Period. That was the extent of my focus.

Reset.

Conversations went from ‘I don’t like the color of the new Hoka running shoes and downtown parking is nutso….’ to ‘Are your family and friends safe? Do you still have your job?’ And then taking the time to really listen to the answers.

Reset.

A conversation in April with a good friend crystalized and cemented what I’d been noodling for a few weeks: social media was an increasingly toxic element in my world. I was as addicted to the dopamine hit and validation that come with ‘likes’ as the next person. Yet I could see that I had reached a point of consistently looking at a post and being able to answer ‘did this enrich my life and inform me of something worth knowing?’ with a rapid, flat ‘nope’.

I hit social media to escape the real world and suddenly internet-misery and anger and half-truths were morphing into the real world for me. I would quote ‘some random friend on Facebook’ as a given expert. I found myself endlessly comparing myself to and judging others. Two of the things I don’t like to engage in at all, ever, were becoming all-consuming end-games on social media for me.

I would scroll and judge. I would scroll and feel like a steaming pile of crap. I would scroll and be irritated or upset or find myself unfollowing people for their posts… Rarely would I scroll and feel happy, smart or enlightened.

Sound familiar at all?

As I scrolled I would think: ‘They’ are doing way better at staying active and fit and they don’t have to battle their weight. That’s really what ‘they’ think science is all about? ‘They’ are sure acting self-righteous in their blanket pandemic-shaming of others without knowing the situation or abilities or problems others face. ‘They’re’ whiny. ‘They’ aren’t even taking a moment to acknowledge the suffering consuming the world around them…. Throw in a daily smattering of random posts covering pandemic-shaming, racism, judgement, fat-shaming and political pandering and you have….

Huh.

FREAKING Reset.

PUSH THE RESET BUTTON NOW.

The part of me that wants to assume the best in people would start showing up when I was NOT scrolling… Who the hell am I to judge anyone for anything? Everyone is doing their very best to hang on and BE who they are in the middle of this chaos. Survival and thriving and getting-by sure looks very, very different for everyone.

You get the brutally ugly idea.

The inside of my head wasn’t the place I wanted it to be when I was scrolling.

Ugh. ‘THEY’ were driving me crazy. And with something ridiculous like 4,000 FB ‘friends’ I don’t even know who most of ‘they’ are! I was comparing and judging and feeling snarky and in many cases with people I do not even know in real life.

Give me a break. That’s not me. That’s not how I want to show up in this world. Social media was hardening my heart, numbing my brain and forcing thoughts to the front of my mind that just didn’t ring true.

And – light bulb! – I actually have a whole lot of control over that input. I needed to practice feeding my brain better experiences and information. I started with pulling the plug on social media interactions and to see if that worked…

I deleted the apps about 5 weeks ago.

The first day or two without FaceBook/Instagram/Twitter were admittedly odd — simply for missing the habit of scrolling or using the phone to fill gaps of silence/boredom. Very quickly I figured out that I missed the HABIT, not the content. With that breathe of knowledge – I knew I’d made the right decision.

It’s been…Glorious. So freeing to be disconnected from the artificial and not-always-so-nice world of social media and yet be more intentionally connected to the voices and hearts of the people in my real world.

I’m not sure when I’ll be back on social media platforms. When and if I do come back, it will be with a simple plan to keep social media as a time-appropriate and mildly entertaining distraction. I don’t make a living on social media and most of the folks who need to find me can easily connect to me in other ways. I have the luxury of choice. And I’m exercising it.

What has my unplugging from social media done for me? Here’s what I’ve observed so far: I am comparing less. Finding more in life to simply enjoy. Less distracted. More connected. More sure of myself. Listening more intently and hearing a whole lot more than just what’s being said. More satisfied with my own life.

Your turn: Have you taken a break from social media? What did you learn? I’d genuinely enjoy hearing what others are experiencing or ways you’ve found to enjoy social media instead of reacting to it… Please reply or leave comments on this blog. Given my hiatus from social media, I’m not likely to see your comments or thoughts otherwise!

Escalation…

I rarely get outwardly mad. It takes a lot to push me to that point. Yet, even if I am angry – I loathe confrontation… And just for fun, let’s throw in that I’m also a professional-level people-pleaser. My disdain for confronting things/people if they make me mad often shows up as a refusal to stand-up for myself so I don’t make anyone else uncomfortable. I have spent my life stuffing down emotions and not confronting anyone if at all possible.

I mean – if you mess with my nephews or my friends; I’ll confront you. And you might not like me or ever forget the encounter. I’m wildly protective of my people.

But make me mad or mistreat me?

Eh. I’m likely to internalize it, spend hours with self-blame trying to figure out what I did to provoke anger or mistreatment and pretend like NOTHING AT ALL is wrong. I don’t love that about myself and never have, yet figured it was just a quirk of my personality and because no one beyond me was bothered, there was no real harm being done.

Well… Turns out non-confrontation and hiding emotions are at the root of my eating disorder and ignoring them (surprise!) really doesn’t work so well… So at 51 I am learning to manage anger, discomfort and confrontation for my overall physical and mental health. After 18 months of therapy, with a really good therapist, I finally feel I have some good tools to use when I do want to express myself. The coping skills, for one of the first times in my life, don’t involve abusing or restricting food.


I went to a new primary doc a few weeks ago. I have been trying to establish one since I moved to Bend. I have struck out. Nice people, general disease management; none of them seem to get my type 2 diabetic past and my desire to stay off of meds. All of this makes me miss Dr. Marske a lot… She and I didn’t always get things right; but she never gave up on me trying to help myself and she always listened to me. Always. I continue to appreciate and better understand what a gift I had in my relationship with this special doctor.

As I briefly explain my history and my desire and efforts to stay off meds to these new doctors, I watch their faces shut down before they even hear me out. Usually around the time I say ‘… I reversed type 2 diabetes by eating low carb and I now run ultras…’ I always think they figure I’m in cahoots with Dr. Google, will grasp on any ‘fad’ and maybe that I’m even trying to tell them how to do their job; which isn’t the case. None of it. I acknowledge that a patient educated in their own disease, their own healing and ardently eager to be a part of the solution might get confused with someone seeking a specific answer/drug/remedy.

I met with this most recent new doc and when asked the reason for the visit, I told her that I was there for three things; a flu shot, survival tactics for perimenopasuse and a referral to an endocrinologist since I was concerned with my fasting blood sugars being higher than I liked (per my own daily testing with a glucometer). I told her I was pretty sure the perimenopausal crap that I’m suffering and the elevated glucose readings are related; but I just can’t seem to figure out the connection well enough on my own to manage it. I admitted I was getting concerned about what I was sure was an elevated – with no stopping in sight – A1c. I told her I was nervous and frustrated because the things I had done to lose 200 pounds, reverse type 2 diabetes and wean off of insulin were NOT WORKING in the same ways they had for the past 7 years.

After a volley back and forth she finally said ‘I appreciate that you are concerned. I don’t feel you should be worried, your daily fasting numbers are well within an acceptable range. But for good measure let’s first test your thyroid just to check things out…’

Sigh.

I was worried about my A1c. It’s a marker I understand well. And I was doing all the same things day to day and the numbers were moving… In the wrong direction. And I know from years of experience that if the daily fasting are too high (the math is pretty simple) the average will be HIGHER – which is NOT what I was after…. My numbers weren’t fine – my gut KNEW it before the blood test would confirm it. I also knew my thyroid wasn’t the issue – yet I appreciate a doc wanting to rule things out with their own tests/eyes/facts. I get all of that. (BTW, snarky side note, ask any fat woman and she will tell you that every doc tests her thyroid as a possible culprit for weight gain. Any. Doctor. All. The. Time. I’ve had my thyroid checked a bazillion times. Even as recently as a year ago – all was well. The ‘thyroid check’ is hotly annoying at this point, AND before anyone jumps me about it; I know it’s due diligence. Doesn’t mean it isn’t annoying.)

As I was listening to this doc work through her perfunctory checklist and essentially brush off my concerns; I was done…

I suddenly realized I was frustrated. And maybe ‘mad’ was starting to surface…

Not at her specifically, but cumulative upset at the health care system that seems set-up to ignore the patients, prescribe meds and – in my uncharitable and arguably jaded opinion – ignore that the WHOLE body needs to be working together.

I am done with docs not listening to me and not taking my experience with this disease into account. I am done with being caught in a disease management system that throws around the word wellness and doesn’t mean anything by it unless they can prescribe it in a pill bottle. I am done with trying to convince a medical professional to be worried for me and to refer me along to someone who specializes in what I live with.

I was not looking to be placated, I was looking for HELP.

I looked her in the eye and said ‘Can you please give me a flu shot. And I agree with you that we should order the blood work so we’re not blindly guessing about my numbers. Thank you.’ I was ready to let ALL the other requests I had floating in the air between us just go away – it was obvious I was going to need to find yet another doctor… Her comment back to me was ‘Even if your number is elevated from the last year; I think the first step is that you need to see a registered dietician so you’re eating a balanced diet and come back to me in six months to re-check your blood work.’

This was the moment I got mad… I felt mad. I felt my face flush and my heart starting to race.

And I decided I was not going to stuff it down this time. So I took a breathe and dug deep and used my new anger-confrontation-communication tools.

I said exactly what I was thinking in calm and even tones. ‘I can’t afford to wait six months. From lots of personal experience with this disease, I know that a dietician isn’t the answer at this point. In fact the Standard American Diet that dietitians are taught to prescribe is exactly what helped land me here in the first place. I can’t convince you that I know I am standing on the edge of life-threatening trouble that I know all too well and I desperately want to avoid again. If I do as you suggest; in six months I’ll be six months sicker and six months further down a road I don’t even want to be on.’

I got the flu shot.

I also got my blood drawn.

And we left things hanging right there…

Turns out my hbA1C (measure of long term blood glucose management) is higher than it has been since I went off of insulin almost 7 years ago. By a lot. I mean I was diagnosed at 11.2. It’s been solidly bouncing around between 4.8-5.2 for over five or six years now. Last week it was 5.9. The measure for pre-diabetes is 5.7-6.4.

I’m technically pre-diabetic again and that is NOT OK…

It is as I feared.

And yet I was and am being told not to worry.

The blood test results, which I accessed on-line simply had a note attached from the doctor that said ‘labs are fine, re-test in 6 months’.

I knew things weren’t right and I’m lucky, on one front, that I have a deep history with this disease and know the basics and when to worry and how to keep pushing for help whether she agrees with me or not. I’m also lucky that this isn’t my word against the world; the blood numbers along with my history with a metabolic disease backs up my concern – and in the right hands that specific information will spur some action and concern. I just have to find that doctor.

I’m still mad. Mostly at the system. But maybe a little mad at the specific doctors that won’t take me seriously and won’t listen.


At the same time all of this was happening I finally and fortuitously connected in real life, via a multiple year Facebook-friendship, with Dr. Mark Cucuzzella in West Virginia. Dr. Cucuzzella is Air Force Reserve Lieutenant Colonel and a Professor at the West Virginia University School of Medicine. He hosts and teaches healthy running medical education courses. He’s also has MODY (maturity-onset diabetes of youth) and he’s an ultra runner. Long ago I reached out on a social media forum asking for advice on eating low carb while also training for and running ultras. He had some really helpful insight and practical solutions that focused on being able to run yet knowing that the end-game was really about steady control of my blood glucose long term.

Dr. Cucuzzella recently invited me to be a part of his healthy running gathering this past November. It was an amazing educational experience with lots of fantastic new connections forged. We finally got to meet face to face. It was awesome to meet one of your long-time advocates and champions in real life for the first time.

So here’s the behind the scenes LONG story short: Dr. Cucuzzella listened to an abbreviated version of my growing frustrations about docs/blood sugars. He said he thought he had a solution for me. He prescribed a Continuous Glucose Monitor (CGM) so that I could do some of my own detective work to figure out what the heck is going on with my blood sugars. I wear this device on the back of my arm 24/7 for 2 weeks at time and monitor, via an app on my phone, how my blood sugars trend given my diet, activity, stress. The ultimate outcome? I should be able to self-correct and adjust my lifestyle choices to get my hbA1c right back down where it belongs. I now have real-time data that I allows me to alter or change things I am eating or doing based on legit, real-time feedback. I’m a week in to this experiment and have collected really interesting data points and implemented some simple changes. It’s empowering and fascinating.

Keep in mind, while this is HUGE for me personally and I’m beyond privileged to have made the connections, taken this trip and to be able to afford to pay for this tool OUT OF POCKET to get the help I need… I had to go from freaking Oregon to West Virginia to find a doc who would listen to me.

But how many people are lucky enough to have a Dr. Cucuzzella in their lives?! I know I have the luxury of insurance. I have the privilege of being able to pay for minor things out of pocket when a doc says it’s important and insurance says ‘not so much’. I know all of that. I take NONE of that for granted. And the fact that this preventative measure is NOT covered by insurance is a WHOLE OTHER blog…

I remain deeply concerned that people have to be their own strident advocates. I remain baffled as to why a system would continue to dissuade/dis-incentivize medical providers from focusing on preventative or lifestyle measures that work. They have scientific PROOF that these lifestyle interventions WORK…. This isn’t voodoo science – they have the data!

I’m upset that the ‘system’ seems content to wait until something has to be prescribed.

I intellectually knew that our health care system is profoundly broken; but I guess this is me arriving waaayyyyy late to the party to say; HOLY SHIT IS THIS BROKEN AND WHAT CAN WE DO ABOUT IT?

I’m standing up for myself and not accepting ‘wait six months’. I’m taking my health back into my own hands.

Yet I’m scared for the people who won’t stand up for themselves or patiently wait simply because they’re paralyzed into overwhelm by the options or are too sick/tired/depressed/scared/poor to keep pushing back on the system…

Or that they trust that the system is doing what’s best for them…

What about them?


I wasn’t asking for a prescription to a controlled substance or to cheat the system or even for a silver bullet. I was asking for help in figuring out why what had worked for so many years was NO LONGER working…

Instead of bottling it all up this time around, or simply being an ostrich and ignoring what’s happening or even choosing to be naive and assume things would ‘work themselves out’, I said what I thought and stated what I needed. I’m very proud of myself for that victory alone. I left her office and went for a run. I got the CGM. I’m collecting my own data and already making tweaks to keep those numbers in a healthy range on the day-to-day. I’m reaching well beyond the confines of our traditional insurance/medical system to get the help I need to stay free from type 2 diabetes…

And yet again I am looking for a new primary doc to work with me.

** 12/2/2019 on the news, as I am writing this blog, they quoted a CDC report (here) that 18% of US Adolescents (12-18 years old) have pre-diabetes. THIS USED TO BE ALMOST EXCLUSIVELY AN ADULT DISEASE… The #1 intervention for prevention/reversal at any life stage for pre-diabetes is lifestyle changes… Preventable. Docs and other folks in the health care system writ large have GOT TO get this prioritizing prescriptions over lifestyle changes thing figured out. Like yesterday. We are running out of time. Lifestyle adaptions and interventions should be the norm; not pills in a bottle… *Stepping off of my soapbox*….

Concussion (Knocking the brain around…)

Your brain is encased in bone for a reason. And when it collides with that bone – things happen…. Bad things.

Most know the bad parts of concussions – and I’m learning that those symptoms and issues vary for everyone, cause of accident and severity. And then positive outcomes seem to vary based on compliance for recovery. You don’t do the right things – you just keep setting yourself back.

I’m not always compliant. To this – I am being obnoxiously compliant.

Lots of water, limited screen time, blue-blocker glasses, keeping stress low, lots of sleep, frequent naps just to close my eyes and maybe a few more naps. I’m keeping my nutrition on point.

While there were some really bad times and symptoms that would stop me in my tracks… There’s also some good that has come about for me in this situation and that is still kind of a shocker…

Good from a concussion? Yes…

I’m funnier. Maybe not a ton funnier – but I swear, I’m funnier. Or maybe it’s just that I’m laughing at myself more. Either way – there’s more laughter in my life. And that’s awesome.

I’m more patient. People are having to express patience with me and my slow thinking and my one arm… While I’m struggling for words, or how to express an emotion or prioritize the need for help or say things I just KNOW coming out of my mouth make no sense… I seem to understand that MAYBE others around me are dealing with something I can’t see or some reason they aren’t in a hurry. And I’m totally OK with that shift to patience. I hate that I can be an impatient asshole sometimes and I’m thinking this perspective shift that humans need a little more patience in their lives is necessary and good – and I’m embracing it.

Binge eating disorder (BED). I hit the ground and gave the almighty amygdala (brain) something ELSE to worry about. And the compulsions surrounding BED seems to be on hiatus. I KNOW I’m not ‘cured’… But this break from those compulsions is a welcomed respite and proof that I can work to gain some relief when it does return. I’d fallen in a 17 month-long pit thinking that those compulsions lurking around every corner were just the new reality for me. This concussion proves that’s not the case. And this gives me hope. Lots of hope.

Help. Asking for help. Struggling through an issue on my own. I’m independent. I really prefer to GIVE help. But I’ve had to ask for help. From little things to big things to embarrassing thing. It’s been a good lesson in letting people help me… Washing hair, running errands, asking questions I know I should know the answers to… And I reached out to others with concussions asking them for their advice and help and to tell me their stories and warnings and best advice. And begging them to tell me that this would get better. Listening intently. And then writing stuff down because I am super forgetful right now. (Thank you Sophia for that tip!) All of this is a great reminder of how I can ask for and give help in the future and stay connected to others who’ve been in my shoes. Humbling, heartfelt reminders are always a good thing…

I’m healing. I’m 28 days post-wreck. Bones mending. I’m barely going to have a scar because my surgeon was amazing. And the concussion symptoms are getting fewer, less, smaller…. And I am heeding all the warnings to enjoy the healing and keep following the precautions.

I lost about 10-14 days of memories post-wreck. I have snippets of memories and snapshots during that time, but it’s sketchy and filled with holes. I spent a lot of time confused and scared and wondering if this was the new normal. I had frequent headaches, blurry vision and would get super fatigued simply from keeping my eyes open. And I’m happy to be on the other side of the worst of it.

It hasn’t all been bad. And that’s pretty damn good.